The technology evaluation theme covers evaluations into the efficacy, effectiveness, costs and broader impact of healthcare interventions. Technology evaluations are funded by the:
Would my primary research idea be of interest to the EME programme or the HTA programme?
Download a pdf of this page (Characteristics of the EME and HTA programmes)
EME Research
The EME programme commissions research that is designed to advance scientific knowledge. EME research is undertaken earlier in the development pathway than HTA research and is undertaken when there is some initial evidence that the technology is efficacious in patients (where proof of concept in humans has already been achieved) but a study is needed to determine definitive proof of clinical efficacy, size of effect, safety and possibly effectiveness. An intervention which is being tested for efficacy must be clearly present in all evaluations, other than diagnostic evaluations.
HTA Research
The HTA programme commissions research that is immediately useful to clinical practice and policy/decision makers. HTA research is undertaken when there is reason to think the technology is efficacious but there is uncertainty around its clinical and cost effectiveness in a real life NHS setting in comparison to the current best alternative(s). There may also be uncertainty around its place in the existing care pathway.
Table comparing typical characteristics of HTA and EME research:
| Characteristic |
EME |
HTA |
Evaluates |
Efficacy, safety and possibly effectiveness of a medical intervention under ideal conditions |
Effectiveness of a medical intervention in a real life NHS setting |
Types of research |
Primary (clinical research)
Usually exploratory research with expert care |
Primary (clinical research)
Secondary (evidence synthesis, e.g. a systematic review or meta analysis)
Usually pragmatic research with routine care |
Stages of research |
EME would consider research which has already been successful in the first stages of testing in humans (often volunteers), and where the required intensity/level/dose of an intervention has been decided
EME research would be specifically designed to evaluate efficacy and whether the treatment works under ideal conditions, and may gather further information on safety |
HTA research would normally follow that which is suited to the EME programme, however there is some overlap with the later stages of EME research
The main focus of HTA research is long-term effectiveness and the impact on patients’ quality of life as well as cost effectiveness. These studies would evaluate effectiveness in a real-world NHS setting |
Design |
A clinical trial or evaluative study (not necessarily an RCT). May also include laboratory based, or similar studies that are embedded within the main EME study |
Often a pragmatic randomised controlled trial although other study designs may be used for instance in the evaluation of diagnostic tests |
Participant eligibility criteria |
More stringent and not necessarily representative of the UK population |
Wide and representative of the UK population and reflects the mix of patients likely to be seen in normal clinical practice |
No. of participants & centres |
Small to Large - may be single or multi-centre |
Generally large – adequate to assess minimally important differences from a patient perspective; usually multi-centre generating results that are generalisable to the NHS |
Technology* |
Mostly developed and defined but some refinement / fine tuning may still be needed |
Fully defined and developed technology |
Comparator |
Likely to be placebo but could be usual care or the best active alternative |
The best active alternative or usual care. Placebos may be used in conjunction with best treatment to blind trial participants |
Outcomes |
Validated surrogate markers as indicators of health outcome are acceptable
|
Clinically important outcomes that matter to patients and that measure health gain |
Follow up |
Sufficient for the outcome to be manifest. When surrogate outcomes are used, for example, this may be shorter than in typical HTA research |
Sufficient to ensure that a wider range of effects are identified other than those which are evident immediately after treatment |
Health economic component included? |
Not usually |
Usually cost-utility or cost effectiveness |
Can a mechanistic evaluation be included as part of the main study? |
Yes. Evaluations which help to understand how an intervention works, or how behaviour affects or is affected by an intervention, may be included as part of the main EME study |
Not usually, it would only be a secondary consideration to assessing cost-effectiveness |
Diagnostic evaluations |
Likely to support validation of a diagnostic test
Unlikely to include evaluations which seek to determine the effects of introducing a new diagnostic test into clinical practice
|
Unlikely to support evaluations which seek to determine the normal range of values for a diagnostic test through observational studies in healthy people
Likely to support the evaluation of cost effectiveness in routine clinical practice |
*By “technology” we mean any method used to promote health, prevent and treat disease and improve rehabilitation or long-term care. “Technologies” in this context are not confined to new drugs but include procedures, devices, tests, settings of care, screening programmes and any intervention used in the treatment, prevention or diagnosis of disease.
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